brigham and women's rotator cuff repair protocol

Tell your provider if you have a history of bleeding disorders or if you're taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. Find PDFs of our most common rehabilitation protocols. %PDF-1.7 The stitches or surgical staples will be removed during a follow-up office visit. Dr. O'Holleran is Fellow, Harvard Shoulder . Rotator Cuff Repair (Arthroscopic) This protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase. 2009-11-17T11:36:40-05:00 This protocol will vary in length and aggressiveness depending on factors such as: smoking, hypercholesterolemia and diabetes. Rotator cuff degeneration and tears may also be caused by aging. Back to Rehabilitation Services Physical Therapy Protocols The following Protocols are the property of Brigham and Women's Hospital (BWH) and are linked here with permission. Most commonly, however, this group of muscles co-contracts and . If pain does not improve with nonsurgical methods, surgery may be recommended. 2023 For more information about these cookies and the data The rotator cuff keeps the shoulder in the socket. Brigham and Women's Hospital, Boston. The intent of posting these standards of care and protocols is to provide clinicians and patients an understanding of our current standards of care and protocols at BWH. Rotator cuff tears (RCT) are frequent and increase with age, yet the varying functional implications of a tear can have a unique and dramatic impact on a patient's daily life. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. For very large tears, physical therapy may be delayed to promote rotator cuff healing up to 6 weeks postoperatively. The rotator cuff may be damaged from a fall or other injury to the shoulder. endobj Van der Meijden OA, W. P . We offer diagnostic and treatment options for common and complex medical conditions. Offering comprehensive medical, surgical and psychiatric care as well as complete emergency, ambulatory and diagnostic services to residents of southwest Boston and the surrounding suburbs. The rotator cuff consists of muscles and tendons that hold the shoulder in place and allows a person to lift his and her arm and reach up. Its one of the most important parts of the shoulder. to analyze our web traffic. They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. Operative report should be read to determine the extent of rotator cuff involvement, integrity of the articular surface, involvement of the biceps tendon and glenoid labrum. The arthroscope is often used in conjunction with other tools that are inserted through another incision. Shoulder injuries are common. collected, please refer to our Privacy Policy. Stay Informed. Regain range of motion 5. Rk.*Ec;g[tG$uVR/vr{O'?= 0?~zEq;*_~f~*axq{qz"ez*^L3_'0/B/''`Do5(C ORs"5>:x8= w l=q6[:!P nh;$+{/Ca p(3QOWhPj0*dpJLOq(X/_l,8Vy/_d0[ g|N!$e$=~HC=:"@("mK0e4o{p$`Y??D :]Lco139R;K)=QUvz x|r =p+43 It consists of a system of lenses, a small video camera, and a light for viewing. 617-732-5500, Rehabilitation Services - Physical and Occupational Therapy, Arthroscopic Anterior Shoulder Stabilization Protocol, Latissimus Dorsi Tendon Transfer Protocol, Open Anterior Shoulder Stabilization Protocol, Posterior and Posterior Inferior Capsular Shift of the Shoulder Protocol, Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF), Reverse (Inverse) Total Shoulder Arthroplasty Protocol, Rotator Cuff Repair Small to Medium Tear, Rotator Cuff Repair Large to Massive Tear, Ulnar Collatoral Ligament of the Elbow Reconstruction Protocol, Autologous Chondrocyte Implantation Protocol, Medial Patellofemoral Ligament (MPFL) Reconstruction, Post-operative Rehabilitation Protocol following Arthroscopic Hip Surgery for Femoroacetabular Impingement, Ankle Fracture with Open Reduction and Internal Fixation (ORIF), Brostrom Gould Repair for Ankle Instability, Functional Activity Progression Protocol following Lower Extremity Stress Injury, Return to Sport Following Knee Injury/Surgery, Running Injury Prevention Tips & Return to Running Program, Running Injury Prevention Tips & Strength Training Program, Reverse (Inverse) Total Shoulder Arthroplasty, Anterior Cruciate Ligament (ACL) Non-surgical Management, Non-Operative Management of Labral Tear of the Hip, Pelvic Floor Considerations in the Transgender and Gender Nonconforming Patient, Breast Reconstruction following Mastectomy, Physical Therapy Treatment of Blocked Milk Ducts, Inpatient-Specific Physical Therapy Standards of Care, Inpatient PT and OT Services: Main Campus, Anesthesiology, Perioperative and Pain Medicine. <> Day 1 - 3 weeks. Learn about career opportunities, search for positions and apply for a job. endobj An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand or develop over time due to repetitive activities. 617-732-5500, Learn more about our sports medicine offerings, Rotator Cuff Tears: Frequently Asked Questions, Rotator Cuff Tears: Surgical Treatment Options, Rotator Cuff and Shoulder Conditioning Program, Anesthesiology, Perioperative and Pain Medicine. This may include shaving off bone spurs that are pinching the shoulder or repairing torn tendons or muscles in the shoulder. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. We use cookies and other tools to enhance your experience on our website and The tendons attach the humerus to the shoulder blade and aids in lifting and rotating the arm. Your provider will explain the procedure to you. %gN+K(( 8VC|[WN#( Y2,,-_:,=t6h(#9 We use cookies and other tools to enhance your experience on our website and Expect full recovery to take up to 4 to 6 months. Take a pain reliever for soreness as recommended by your healthcare provider. The rotator cuff consists of muscles and tendons that hold the shoulder in place and allows a person to lift his and her arm and reach up. 2012-04-12T06:10:33-04:00 Quick Links. SUBSCAPULARIS REPAIR REHABILITATION PROTOCOL ! %PDF-1.6 % endobj Rehabilitation after Rotator Cuff Repair. An arthroscope is a small, tube-shaped instrument that is inserted into a joint. NEW HARTFORD. Rotator Cuff Repair with Biceps Tenotomy/Tenodesis Post-Operative Protocol Phase I - Maximum Protection (Weeks 0 to 6): Goals: o Reduce inflammation o Decrease pain o Postural education o PROM as instructed Restrictions/Exercise Progression: o Sling for 6 weeks per Dr. Bjerke's instructions 1 The intent of this Protocol is to provide the clinician with a guideline for the post-operative rehabilitation course of a patient that has undergone a Flexor Tendon Repair.It is by no means Brigham AND women 'S HOSPITAL intended to be a substitute for one's clinical decision-making regarding the progression of a A Teaching Affiliate of Harvard Medical School patient's post-operative course . Maintain good upright shoulder girdle posture at all times and especially during sling use. If medical treatments aren't working, rotator cuff repair surgery may be an effective treatment. Rotator Cuff Repair Rehab Protocol-Brigham and Women's Hospital. An open repair may be performed if the rotator cuff injury cannot be repaired using arthroscopy. skip to Cookie . Acrobat Distiller 8.0.0 (Windows) When may I start strengthening? A sterile bandage or dressing will be applied. Once your blood pressure, pulse, and breathing are stable and you're alert, you'll be taken to your hospital room or discharged to your home. augment suture repair of the rotator armband tendon in 2 stud-. It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. Stay Informed. You shouldn't drive until your surgeon tells you to. COPYRIGHT*2014*CRC*"BRIAN*J. Using sutures and suture anchors, the torn muscle and tendon are sewn back to the bone where it was originally attached. Thigpen, C. A. 1 Chung SW et al. If you believe you should have an evaluation and would like to schedule an appointment with one of our orthopaedic surgeons for rotator cuff surgery, knee replacement surgery or hip replacement surgery, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form. Brigham and Womens Hospital has long been committed to not only the care of our patients but also the many other needs that they and their families have. The intent of posting these criteria a care and protocols a to provide clinicians and patients an understanding of ours current standards of care and protocols at BWH. Rotator cuff surgery may be done using an arthroscope. mqTdYqc#\*DgVx?,a6&&tO"TP_YV{zYNm[ Dj?mk^(^N7K1_Q P ? +!B8p+*.QnMXNjtt Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. There may be other risks depending on your specific medical condition. Our inpatient satisfaction survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and what areas may need improvement. Tell your provider about all prescription and over-the-counter medicines and herbal supplements that you're taking. The conservative rehabilitation protocol allows Sharpey fibers to form before stressing the repair with resistive exercises. Connect with us. `6B3}"{PT(3 _x g"8. Women's Orthopedic and Joint Disease Center, Anesthesiology, Perioperative and Pain Medicine. Some possible complications may include: The joint pain and weakness may not be relieved by the surgery. Read the form carefully and ask questions if something isn't clear. Shoulder Precautions This information is not intended as a substitute for professional medical care. The rotator cuff is a slow healing structure due to poor blood supply. General Information: 02114. Rehab Plans and Exercises Minor Rotator Cuff Repair Protocol for Physiotherapy Following Surgery. You may not recover full range of motion in the shoulder joint. To help reduce swelling, you may be asked to apply an ice bag to the shoulder several times per day for the first few days. Learn about Real Therapy Standards of Care and Protocols since that Rehabilitation Services at Brightam additionally Women's Infirmary. An arm sling is used for 4 weeks post-op. If regional anesthesia is used, you'll have no feeling in your shoulder. Before you agree to the test or the procedure make sure you know: The reason you're having the test or procedure, What results to expect and what they mean, The risks and benefits of the test or procedure, What the possible side effects or complications are, When and where you're to have the test or procedure, Who will do the test or procedure and what that persons qualifications are, What would happen if you didn't have the test or procedure, Any alternative tests or procedures to think about, Who to call after the test or procedure if you have questions or problems, How much you'll have to pay for the test or procedure. Your provider will arrange for an exercise rehabilitation program to help you regain muscle strength, flexibility, and function of your shoulder. 3. QlR#D' L|5C[[ZW%pGY8JMe{+u'O=1m The anesthesiologist or nurse anesthetist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. MA General Information: The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. You may resume your normal diet unless your provider advises you differently. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on . Tell your provider if you're sensitive to or allergic to any medicines, latex, tape, and anesthetic agents (local and general). vywh0*-)Ha[ %2+$t^> K5$*{c Z Q.@B[,4nr^{.zlqE@`Cu.> Arthroscopic Rotator Cuff Repair Protocol: The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation course of a patient that has undergone an arthroscopic assisted/mini-open rotator cuff repair. Continue to emphasize scapular stabilizers. 175 Cambridge Street, 4th Floor Procedures may vary depending on your condition and your providers practices. Call 617-643-3333 if youre experiencing a sports injury. General Information: Rehabilitation after Arthroscopic Labrum Repair of the Shoulder (SLAP) Phase One: 0 to 4 weeks after surgery Goals: 1. 1 Oxford Road New Hartford, NY 13413. 4. You may undergo blood tests or other diagnostic tests. For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. 617-732-5500, New Patients: It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. Healing occurs at a rate of 10% per month. The rotator cuff may be damaged from a fall or other injury to the shoulder. A surgical repair is indicated when pain cannot be managed with conservative methods and is associated with weakness that causes a significant loss of function. Get the latest news, explore events and connect with Mass General. You can ask questions. Connect with us. Protocol Delays: o The start of this protocol will be delayed 3-4 weeks following rTSR for a revision or in the presence of poor bone stock based on the surgeon's assessment of the integrity of the surgical repair. /*jthpUxYl*ABB'.4dG^td}AU Be sure to discuss any concerns with your provider before the procedure. collected, please refer to our Privacy Policy. endobj /-BmN2'ux)>MxYLV#a$F]7W9.|EzuonDxH/?uXPoN,);? An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand or develop over time due to repetitive activities. HMn0F:N@_A"'( -P7Ul8 >qr5i>M___c*h?) Generally, rotator cuff repair surgery follows this process: You'll be asked to remove clothing and given a gown to wear. Adobe Acrobat 8.0 Combine Files Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and following established protocols that have been shown to improve patient outcomes. BRIGHAM AND WOMEN'S HOSPITAL. The goal of rotator cuff repair surgery is to help restore the function and flexibility of the shoulder and to relieve the pain that cannot be controlled by other treatments. uuid:5fa44141-9c8c-4c9c-b6ca-f862302a5ebb ROM Exercises; Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers. These treatments may include: rest, activity modification, non-steroidal anti-inflammatory medication and physical therapy. Stay Informed. The information contained in these standards of care or protocols is not intended in any way to be used as primary medical advice or to replace medical advice offered by physical, occupational, speech therapists or other health care professionals. Medical treatments for rotator cuff injury may include the following: Nonsteroidal anti-inflammatory drugs (NSAIDs). This protocol is time based (dependent on tissue healing) as well as criterion based. At Mass General, the brightest minds in medicine collaborate on behalf of our patients to bridge innovation science with state-of-the-art clinical medicine. . Journal of Shoulder and Elbow Surgery, 4:521-535. For more information, please visit the following webpages on orthoinfo.org: Please visit orthoinfo.org if your condition is not listed above. An open repair may be done if the rotator cuff injury cant be repaired using arthroscopy. 800-294-9999. Arthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears: The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair. x=n8zE$ The rotator cuff keeps the shoulder in the socket. Brigham and Women's Faulkner Hospital Rehabilitation Services 1153 Centre Street - 2nd Floor Boston, MA 02130 617-983-7271 General Information Arthroscopic Rotator Cuff Repair is performed when there is a tear of one or more of the four muscles that comprise the Rotator Cuff. stream 2 0 obj The camera is connected to a monitoring system that allows the surgeon to view a joint through a very small incision. There may be other reasons for your healthcare provider to recommend rotator cuff repair. Rehab Plans and Exercises Minor Rotator Cuff Repair Protocol for Physiotherapy Following Surgery. You'll be asked to sign a consent form that gives your permission to do the procedure. collected, please refer to our Privacy Policy. Small/Medium Rotator Cuff Repair Protocol; Subscapularis Repair Protocol; Superior Capsule Repair Protocol; Triceps Tendon Repair Protocol; Locations: HAMILTON. Mass General Brigham's Sports Medicine Program now offers urgent access virtual visits. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. <>/Metadata 1084 0 R/ViewerPreferences 1085 0 R>> Your surgeon will give you specific bathing instructions. It allows you to lift your arm and reach up. We pride ourselves in the quality of patient care we provide and how we compare with other hospitals. The rotator cuff is a group of four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. Rotator cuff strengthening with light Theraband - ER and IR with arm at side and pillow or towel roll under arm - Flexion to 60 degrees - Abduction to 60 degrees - Scaption to 60 degrees - Extension to 30 degrees Standing rows with Theraband Prone scapular retraction exercises (with light weight) Ball on wall (arcs, alphabet) Stay Informed. application/pdf Explore fellowships, residencies, internships and other educational opportunities. The presence of a RCT can cause a vast array of impairments and associated dysfunctions. The following Standards is Care and Protocols are the real away BWH and should not be copied or otherwise used without the get of the Director of Rehabilitation Services. Reverse or inverse total shoulder arthroplasty (rTSA) is becoming a widely accepted surgical intervention. to analyze our web traffic. Damage may also happen slowly over time. endobj Frequency of treatment will be determined by your specific needs together with the physician and physical therapist recommendations. Your provider will discuss this with you in advance. ntr>&TZt`3o6?=^_.9|0dd\H c9{+'+::A{NhV{. MD follow-up visits at Day 1, Day 14 . Avoid excessive reaching and external/internal rotation for the first 6 weeks. }@o~+msq8JJ|vd24a2e> In the case of a delayed therapy start, the following timeframes are to be adjusted so that day 1 is the first day of therapy. This usually involves reattaching the tendon to the head of the humerus. The conservative approach may be associated with post-operative stiffness which can be managed once healing has occurred. Women's Sports Medicine Rotator Cuff Repair The shoulder is a ball-and-socket joint: the head of the humerus (upper arm bone) fits into a socket in the shoulder blade. *COLE,*MD,*MBA RANGE OF MOTION IMMOBILIZER EXERCISES PHASE I 0-6 weeks 0-3 weeks: None 3-6 weeks: Begin PROM Limit 90 flexion, 45 ER, 20 extension 0-2 weeks: Immobilized at all times day and night Off for hygiene and gentle home exercise according to PROM shoulder flexion/abduction/ER/IR. Full recovery from the surgery may take several months. Recurrent pain, limited ability to move the arm, and muscle weakness are the most common symptoms. Physical Therapy Protocols Shoulder Elbow Hip/Knee Ankle Return to Sports Guidelines Physical Therapy Standards of Care Ankle Spine Shoulder Hip/Knee Lower Extremity Pelvic Health Medical treatments for rotator cuff injury may include, but are not limited to, the following: If medical treatments are not satisfactory, rotator cuff surgery may be an effective treatment for shoulder repair. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 32 0 R 33 0 R 34 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> biceps tenodesis procedure involves cutting of the long head of the biceps just prior to its insertion on the superior labrum and then anchoring the tendon along its anatomical course more distally along the humerus. Copyright 2007-2023. HWMo8W(oQ@QIECw^8++kJdGvqd7FWzj7,N.NlI~Kk6}b6}%O, Microsoft Word - Rotator cuff and SLAP patient info.doc. All rights reserved. It consists of a system of lenses, a small video camera, and a light for viewing. The circulation and sensation of your arm will be monitored. If your rotator cuff is injured, you may need to repair it surgically. ajp5 Tell your provider about any of the following: Redness, swelling, bleeding, or other drainage from the incision site, Numbness or tingling in the affected arm or hand. Brigham and Women's Hospital, Division of Rheumatology, Inflammation, and Immunity, nonsteroidal anti-inflammatory medications. 5. The arthroscope (if used) will be put through the incision. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. If the rotator cuff is injured, it may need to be repaired surgically. The type of anesthesia will depend on the specific procedure being done. ;#O#t4\i_"+O/G?|tg1}*$27VsO] k\pU2=" You will eventually be prescribed strengthening exercises. You may be given an immobilizer or sling before you go home. Mastersling with body . Surgery for rotator cuff repair involves the reattachment of the tendon to the humeral head. Once youre home, its important to keep the surgical area clean and dry. Ensure wound healing 3. x][~G[" $`u[6=nwgz~HH[6M} ^|jg4?/>=W6ugqAxi??='O71R +gA^V%w?h0J6 }l?x)?VQ,QK-XTS1aM Control pain and swelling Activities: 1. endstream endobj 770 0 obj<>stream

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